Nokea
A patient develops a superinfection due to fluoroquinolone therapy. The patient asks the nurse why this happened. Which response by the nurse would be most appropriate?
- A. Your infection was really severe, so the drug wasn't as effective as it could have been.
- B. This happens when your original infection begins to clear.
- C. The drug disrupts your normal bacteria so it allows other organisms to grow.
- D. We really don't know why this happens; it just does sometimes.
Correct Answer: C
Rationale: Antibiotics can disrupt the normal flora (nonpathogenic bacteria in the bowel), causing a secondary infection or superinfection. This new infection is 'superimposed' on the original infection. The destruction of large numbers of nonpathogenic bacteria (normal flora) by the antibiotic alters the chemical environment. This allows uncontrolled growth of bacteria or fungal microorganisms that are not affected by the antibiotic being administered. It has nothing to do with the drug's effectiveness or the original infection being cleared.
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A nurse is preparing to administer ciprofloxacin as ordered. Which test would the nurse ensure is completed before administering the first dose to the patient?
- A. Urinalysis
- B. Culture tests
- C. Ulcer tests
- D. Stool tests
Correct Answer: B
Rationale: The nurse should check whether culture tests are conducted before the first dose of drug, is administered to the client. Ulcer tests and stool tests are not required to be conducted before administering the first dose of an anti-infective drug to the client. The nurse has to ensure that urinalysis is conducted before the administration of the drug but not specifically before the first dose of the anti-infective drug.
The nurse is reviewing the medical records of several clients with infection. The nurse would anticipate the prescriber ordering a fluoroquinolone for a client with which of the following? Select all that apply.
- A. Unitary tract infections
- B. Sexually transmitted infections
- C. Upper respiratory tract infections
- D. Bone and joint infections
- E. Skin infections
Correct Answer: A,B,D,E
Rationale: Fluoroquinolones are primarily used to treat lower respiratory tract infections, bone and joint infections, urinary tract infections, skin infections, sexually transmitted infections, and some infections of the eye and ear.
Prior to administration of moxifloxacin (Avelox), a nurse obtains a medication history. Use of which drug would alert the nurse to contact the prescriber because concomitant use would lead to an increased risk for a severe cardiac arrhythmia? Select all that apply.
- A. Amiodarone (Pacerone)
- B. Glyburide (DiaBeta)
- C. Solaid (Betapace)
- D. Procainamide (Procanbid)
- E. Ibuprofen (Motrin)
Correct Answer: A,C,D
Rationale: There is a risk of severe cardiac arrhythmias when moxifloxacin (Avelox) is administered with drugs that increase the QT interval, such as quinidine, procainamide, amiodarone, or sotalol.
Fluoroquinolones should be used with caution in which of the following clients? Select all that apply.
- A. Clients with diabetes
- B. Clients with hypertension
- C. Clients receiving dialysis
- D. Clients with chronic obstructive pulmonary disorder (COPD)
- E. Clients with epilepsy
Correct Answer: A,C,E
Rationale: Fluoroquinolones should be used with caution in clients with diabetes, renal impairment, or history of seizures, older clients, and clients on dialysis.
A nurse is caring for a client who is receiving a fluoroquinolone as an intravenous infusion. The nurse would check the infusion rate at which frequency?
- A. Every 15 minutes
- B. Every 30 minutes
- C. Every 45 minutes
- D. Every 60 minutes
Correct Answer: A
Rationale: When administering a fluoroquinolone IV, the nurse should check the infusion rate every 15 minutes and adjust it if necessary.